Have realistic expectations about plastic surgery

If you’re on the gray side of 40 in our look-at-me culture, you’ve stared into a mirror and seen yourself slipping into decrepitude like fingers on an icy ledge. You decide maybe some “work” needs to be done.

However, if you’re thinking of plastic surgery to make you look younger, don’t do it. I repeat, do not do it. I have that from an expert, but more on that later.

When we go to gossip websites to get our celebrity fix, we stare critically at photos of stars and wonder how much plastic surgery was required for them to always look terrific. (But, of course, we never see how they look at 7 a.m.)

Then, we go to other websites and check out the “face-lifts from hell” and think, “Oh, oh.”

Thus begins our curiosity about the surgery that has us holding our breath and reaching for a mirror when the bandages come off.

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Tim Miller, M.D., is a top cosmetic and reconstructive surgeon in Los Angeles and an emeritus professor at UCLA Medical Center. That means he has worked on some of those beautiful people on tmz.com and in People magazine. His peer reputation rests on his reconstructive work with burned and disfigured patients, but the two things are first cousins. They both involve reshaping flesh.

Miller is an approachable, energetic man of 74 who grew up in La Mesa and holds the Bronze Star for doctoring villagers while getting shot at in Vietnam. Before he tackled our topic, he lightly groused about having strained a muscle lifting weights at his Mulholland Drive home high above the lights of L.A.

You and I are not movie stars, but we need advice as much as Warren Beatty (not that he’s had work done, wink, wink).

I first asked Miller to react to a plastic surgery advertisement I saw that promised to make patients look 15 years younger.

“I don’t like that. I personally don’t think it’s appropriate.”

Looking younger is not the proper purpose for cosmetic surgery, he says. “The goal should be to look better. People know you’re, say, 50, so an attempt to look 30 fools no one. Everyone has seen someone who’s had plastic surgery, and their face doesn’t look consistent with the rest of their body.

“If people ask, ‘How many years will this take away?’ I tell them, ‘It’s not going to take any years away. It’s going to make you look better.’ ”

What is the worst motive for having plastic surgery?

“There are several: Having unrealistic expectations, doing it for someone else, to attract or keep a mate, or to get a job. That takes the surgery away from the person. You do it to look your best. That’s a healthy sense of vanity. If you see extra skin on your face and you would like it removed or tightened to enhance your looks, there’s nothing wrong with that. You want to look like yourself, but look better.”

Let me ask about what you call a breast augmentation, but all the rest of us call a boob job. Does the motivation for that come from the patient or from a man in her life?